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ID:42277629
大小:1.77 MB
页数:31页
时间:2019-09-11
《代谢综合症:预防心脏病的前景》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、MetabolicSyndrome:APerspectiveinPreventiveCardiologyZhaoDongDepartmentofEpidemiologyBeijingInstituteofHeart,Lung&BloodVesselDiseasesBeijingAnzhenHospitalFocusesofCurrentDebatesinMetabolicSyndromeDefinitions??????Etiologyandpathophysiology??????Clinicalimportance???????ImportanceforCVDpreventi
2、on???????ClinicalPerspectivesforMS●WhoaretheMSpatients??(Diagnosticissue)●WhoneedtheclinicaltreatmentamongtheMSpatientsand??●HowtotreattheMSpatients??(Treatmentissue)●Theeffectivenessoftreatmentstrategies??(Treatmentissue)TheProportionofMSbyDifferentCriteriaforCentralObesityMaleFemaleTreatmen
3、tDecisioninMSHypertensionHighBPHighTGDiabetesIFGCentralObesityLowHDL-CWhoneedstreatmentasMSpatients?WhatarethespecifictargetsoftreatmentforMSpatients?PreventivePerspectivesforMS●IfthemajorcomponentsofMShavecommonpathophysiologicalpathway???●IfMShasuniquevalueinpredictionofCVD???●Howtoprevent
4、MS??IfthecomponentsinMShavecommonpathophysiologicalpathway???Humanobesity……isduetoanexcessproductionoffreefattyacidsfromtheselipolyticallyactivedepots.This,inturn,mightcausehyperinsulinemiaviareducedhepaticinsulinuptake,followedbyperipheralhyper-insulinemia,insulinresistanceand,perhaps,diabet
5、esmellitusandhypertension.BjorntorpPJClinHypertension19862:163…….ThesedatastronglysupporttheviewthatinsulinplayanimportantroleinregulationofHDLmetabolism.GolayAJLipidRes198728:10-18AtheroscleroticCVDIGTType2DMdyslipidemiaFFATGHDL-CBPInsulinresistanceBantingLecture:ReavenGM1988Diabetes37:1
6、595Hyperinsulinaemia%ThePrevalenceofHyperinsulinaemiabyIncreasingNumbersofComponentsinMetabolicSyndrome(CMCSStudy,2002)%PercentagesofOnlyOneComponentofMetabolicSyndromeinPeoplewithandwithoutHyperinsulinaemiaHTGHypertensionLowHDLHighGlucose(CMCSStudy,2002)HyperinsulinaemiaInsulinnormal不同FFA和胰岛
7、素抵抗水平时各种代谢综合征组份异常的患病率(%)腹部肥胖高TG血症低HDL-C血症高血糖高血压不同FFA和胰岛素抵抗水平时代谢综合征的患病率(%)代谢综合征患病率%FFA四分位分层胰岛素抵抗四分位分层腹部肥胖高TG血症低HDL-C血症高血糖高血压FFAⅠ─────Ⅱ2.02.8NS1.51.7Ⅲ1.72.4NS2.12.1Ⅳ2.13.9NS3.72.7HOMA_IRⅠ─────Ⅱ1.52.41.62.8NSⅢ2.53.81.95.4NSⅣ2.17.03.428.9NS调整年龄
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